Diabetic Retinopathy Screening May Help Identify Early Cardiovascular Disease

Diabetic retinopathy has been linked to a doubled risk of incident coronary heart disease events as well as a 2.5-times risk of increased likelihood of incident heart failure, according to two studies that analyzed the Atherosclerosis Risk in Communities cohort. Photo: Thomas A. Wong, OD. Click image to enlarge.  Individuals with type 2 diabetes face an elevated risk for cardiovascular conditions. While annual screening for subclinical disease is recommended, the reliability of current tests is easily affected by factors common in this form of diabetes, such as kidney dysfunction, obesity and advancing age.As well, diabetic retinopathy has long been linked with an increased likelihood of developing cardiovascular issues. To determine whether retinal changes can predict subclinical cardiovascular disease, British researchers conducted a subanalysis of the prospective Prevalence and Determinants of Subclinical Cardiovascular Dysfunction in Adults with Type 2 Diabetes (PREDICT) study to explore the connection between diabetic retinopathy and microvasculature geometry with atherosclerotic cardiovascular disease and markers of stage B heart failure. Their recent findings, published in Scientific Reports, support the use of routine eye exams in diabetic patients for the early detection of cardiovascular disease.This study included asymptomatic adults with diabetes and no history of cardiovascular disease. All participants underwent echocardiography, non-contrast coronary computed tomography and cardiovascular MRI. The researchers used a deep learning tool to evaluate and grade fundus photos for diabetic retinopathy and microvascular geometric characteristics.Of the 255 participants, 78% had no diabetic retinopathy and 22% had mild background retinopathy. The researchers found that patients with diabetic retinopathy had a higher burden of coronary atherosclerosis and early heart failure markers such as more concentric left ventricular remodeling and worse global longitudinal strain.Surprisingly, they observed “no direct associations between retinal microvascular geometry and subclinical cardiovascular disease.” The authors say that it’s possible there’s no direct link with these specific cardiac parameters; that the retinal changes were smaller than those typically quantified by the deep learning tools; or that it might be due to variations in fundus cameras used in the routine NHS screenings.They concluded that “routine diabetic eye screening may serve as a clinically relevant and accessible alternative method to currently advocated screening tools for detecting underlying cardiovascular disease in type 2 diabetes.”Click here for the journal source. Alatrany AS, Lakhani K, Cowley AC, et al. The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes. Sci Rep 2025;15:27968. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.